Aix Marseille Université, IRD, AP-HM, SSA, IHU-Méditerranée Infection, VITROME: Tropical and Mediterranean Vectors - Infections, Marseille, France; Université Paris-Diderot, CNRS, LIED: Interdisciplinary Laboratory of Tomorrow's Energies, Paris, France.
Université Paris-Diderot, CNRS, LIED: Interdisciplinary Laboratory of Tomorrow's Energies, Paris, France.
Soc Sci Med. 2019 Jan;220:73-80. doi: 10.1016/j.socscimed.2018.10.032. Epub 2018 Nov 2.
Confronted with a rise in vaccine hesitancy, public health officials increasingly try to involve the public in the policy decision-making process to foster consensus and public acceptability. In public debates and citizen consultations tensions can arise between the principles of science and of democracy. To illustrate this, we analyzed the 2016 citizen consultation on vaccination organized in France. This consultation led to the decision to extend mandatory vaccination.
The analysis combines qualitative and quantitative methods. We analyze the organization of the consultation and its reception using the documents provided by its organizing committee, articles of newsmedia and the contents of 299 vaccine-critical websites. Using methods from computational linguistics, we investigate the 10435 public comments posted to the consultation's official website.
The combination of a narrow framing of debates (how to restore trust in vaccination and raise vaccination coverages) and a specific organization (latitude was given to the orientation committee with a strong presence of medical experts) was successful in avoiding legitimizing vaccine critical arguments. But these choices have been at the expense of a real reflection on the acceptability of mandatory vaccination and it did not quell vaccine-critical mobilizations.
Public health officials must be aware that when trying to increase democratic participation into their decision-making process, how they balance inputs from the various actors and how they frame the discussion determine whether this initiative will provide meaningful information and democratic legitimacy.
面对疫苗犹豫率的上升，公共卫生官员越来越多地试图让公众参与到政策决策过程中，以达成共识并提高公众接受度。在公共辩论和公民咨询中，科学原则和民主原则之间可能会出现紧张关系。为了说明这一点，我们分析了 2016 年在法国组织的一次关于疫苗接种的公民咨询。这次咨询导致了扩大强制接种的决定。
该分析结合了定性和定量方法。我们使用组织委员会提供的文件、新闻媒体的文章以及 299 个疫苗批评网站的内容，分析了咨询的组织和接受情况。使用计算语言学的方法，我们研究了向咨询官方网站发布的 10435 条公众意见。
辩论的狭隘框架（如何恢复对疫苗接种的信任并提高疫苗接种覆盖率）和特定的组织（向立场委员会提供了很大的自由度，其中有很多医学专家）的结合成功地避免了对疫苗批评论点的合法化。但这些选择是以对强制性疫苗接种的可接受性进行真正反思为代价的，而且并没有平息对疫苗的批评动员。
公共卫生官员必须意识到，当他们试图增加决策过程中的民主参与度时，他们如何平衡各方面参与者的投入，以及他们如何构建讨论，这将决定这一举措是否能提供有意义的信息和民主合法性。
